Interim solution is to remove nitrous oxide cylinders and pipelines and cap their connections

EDITOR—Saunders and Meek point out that anaesthetic machines without hypoxic guards confer an appreciable risk.1 Many latent errors in the health system are solved only after tragedies. As the authors say, in an underfunded system the replacement of such machines, at considerable cost (£8000-£40 000 depending on the type of machine), has to compete with many other high priorities for small capital funds. Awaiting replacement leaves patients at risk and is thus unacceptable.

An interim solution could be used in most situations. It is perfectly possible to deliver an anaesthetic without giving nitrous oxide at all; indeed, there are several benefits from avoiding …